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It’s over. Hang-up any hope of actual, effective healthcare reform. This thing is going to get obfuscated, misrepresented, fear-mongered and derailed to a fare-thee-well.
The best you’re going to get is a mandate that everyone must have insurance, no cost controls for either insurance or health industries, and a restricted, underfunded federal subsidy plan that only helps the absolute poorest of the country.

Even Palmer’s rendition appears frighteningly complex. I think it’d be helpful to have a similar diagram prepared that compares the current system to the proposed system to see if the new plan is spinning a tangled web of complexity or removing the knotted cobwebs of the old system.

Yes, the Democratic chart is still way too complicated to represent meaningful reform. Anywhere you see a transition point, expect the redirection of funds away from actual care by various interests.

This ongoing debate has confirmed once-and-for-all that my decision to move back to Canada was a good one. Here I have a level of care that is comparable to my (actually quite good) employer-provided plan in the US, and much easier to access. In the meantime, people who I had thought were otherwise rational adults are trumpeting that they voted “No” to government-managed health care in a Facebook poll.

My primary interest in this story was how the Republicans’ notoriety for reframing a debate to their favor by rephrasing the language of the debate now extends to the language of design. And, as always, Democrats are scrambling to catch up using far less effective tools: beauty and reason.

But there’s no questioning that any overhaul of health care in this country is intensely complicated, and even the Democratic design cannot help but reflect this truth.

I love what it says about design’s influence on emotions more than what information it actually contains or purports to transmit. The angry fonts of the Republican image! The unaesthetic size choices! The grey background that you shall surely sink into, never to be found again! As opposed to the cheery, don’t-be-scared, baby-soft, yet still complex design of the Democratic Party’s effort.

Trying to actually read the charts… the Democrat’s looks just about as complex and initially confusing as the Republican’s. Eesh.

I’m not sure why complex necessarily equals bad, though. Would you convince someone not to buy a car if you showed them a complex graphic of how the car’s different systems were connected together? Would a really simple chart be more reassuring?

Fed Monies ==> Doctors ===> You

If that were the plan, I’d think they hadn’t thought it through very carefully.

Neither the current dysfunctional private insurance system nor the proposed “reform” provide consumer-driven healthcare that addresses those two points.

One of the first things that we can do is double the number of medical students who graduate each year from 18,000 to 36,000. In a 2003 study Dean Baker, who is co-director of the Center for Economic and Policy Research, estimates that by adding roughly 100,000 physicians to our current pool of about 760,000, we could pull doctorsâ€™ salaries down from an average of $203,000 to somewhere between $74,000 and $126,000. For the average middle-class American family of four he reckons that would lead to savings of $2,200 to $3,700 per year.

I’m betting the Canadian chart would be a hairball, but NOTHING compared to one of these trying to depict the current situation in America…

You’d need to track ALL the insurance providers, the various state Medicare programs, the military programs, the efforts of various charitable interests in offering relief to people who can’t be covered by any of the above and can’t afford the ransom the commercial providers charge…

And then you need a flood of arrows pointing out the bottom for all the people who pay a crapton of money into the system and still get rejected because the treatment they need isn’t covered, and all the people who don’t get any coverage at all.

The other great fear of hospital bosses is being forced to accept greater competition. Although the industry is fragmented, Jon Scholl of the Boston Consulting Group points out that because pricing is done at city or regional level, there are â€œlocal pockets of power.â€ Alain Enthoven, an economist at Stanford Universityâ€™s business school who helped inspire the â€œmanaged health careâ€ movement of the 1990s, promoted an approach that succeeded in squeezing costs at the time, but ultimately failed as patients rebelled against the restrictions it placed on their choice of doctors and treatments. Mr Enthoven argues that the consolidation that followed managed care has resulted in too little competition. â€œAntitrust action in the hospital field has been woefully weak,â€ he says.

There are some innovative competitors emerging to challenge hospitals. Paul Keckley of Deloitte, a consultancy, estimates that there are over 1,000 retail health clinics operating today at Wal-Mart stores, Walgreens pharmacies and other convenient locations, and their numbers are expected to multiply in the next few years. Some of these cheap and cheerful outfits are staffed by nurse practitioners (who are much cheaper than doctors), which incenses doctors and hospital bosses.

The nascent boom in medical tourism could also disrupt the hospital business, even if every hip-replacement patient does not actually go to India to get it done. Mr Keckley points out that in several parts of the country the mere introduction of insurance plans offering cheap surgery abroad has forced local hospitals to respond by slashing their pricesâ€”something unheard of in this industry.

Looking at these charts from Canada I see one thing that stands out above everything else: both use the word “consumers” to describe people.

It seems that these days Americans do not talk about themselves as “citizens” or even put things into context by describing what it is they are actually doing. In this case “patients” would be an even better fit for these charts. Why such shallow thinking on this subject?

Consumers?! You clearly just don’t get it. So long as you keep describing all patients as consumers you will continue to bankrupt large portions of your citizenry every year for no good reason.

You can’t have universal health care and still call people consumers. Some people won’t be buying anything. That’s the point.

Both charts could be greatly simplified by removing currently existing beaurocracy, and only showing what would be new or change, or by removing or de-emphasizing some of the internal government parts and only showing or highlighting the parts that directly affect or would be actually visible to an individual citizen (*** can we STOP calling ourselves “Consumers” already? ***), employers, etc.

quick, somebody throw up an infographic detailing how the Pentagon works! Conclusion: Self defense is a complicated gov’t program, so we must get rid of it!!

So what if it’s complicated, some things worth doing are going to be complicated, expensive and require lots of steps and oversight. That doesn’t mean we shouldn’t do them.

What the republicans are trying to do is make people think this will complicate their lives, when in actuality the individuals interaction with the whole system will be somewhat limited to 2 or 3 points of contact. Is that any worse than the current system of insurance and health care?

State of MA: We’re going to enact universal health care in Massachusetts.

Me: Seriously? Wow, that’s awesome!

2006…

State of MA: We now have universal health care! Which means YOU all must buy health care for yourselves. Universally. And you must universally provide proof that you have done so with your tax returns, or you will be universally fined. There are a few subsidies to quiet down you poor people, who don’t currently have insurance because you couldn’t afford it.

In summation, hope you can afford to buy insurance! If not, hope you can afford the fines!

I’ve yet to research enough to formulate an opinion on the health care situation… but what annoys the hell out of me every time I see it, is government or party communications referring to the people as “consumers” rather than “citizens.” There’s been a lot of it on the Cash for Clunkers situation too. Infuriating.

Conservatives for Patients’ Rights, the operation that’s running a national campaign against a public health care option, is now publicly taking credit for helping gin up the sometimes-rowdy outbursts targeting House Dems at town hall meetings around the country, raising questions about their spontaneity.

Oh, joy:

It’s also worth remembering that Conservatives for Patients’ Rights is run by Rick Scott, who is perhaps best known for having been ousted as the head of Columbia/HCA healthcare after a massive fraud investigation. Columbia/HCA ultimately pleaded guilty to a variety of fraud-related charges, paid $1.7 billion in fines, and got rid of their scandal-plagued chief.

Applying the Canadian (or British, or average European) system to the US runs into two problems: 1. We’re fatter down here. The average BMI for a Canadian seems to be around 25.5, versus 28 in the US. Considering that the diseases of obesity are expensive, that’s going to push per-person costs up. While it’s not impossible to get people to slim down, I wouldn’t count on doing it for the next decade or two at least. 2. We spend a hell of a lot of the budget on guns– twice as much as the EU, which has a reasonably comparable population and economy.

There’s not a good way to apply a system built for relatively fit, relatively peaceful people work to butterballs who spend a third of the budget on blowin’ shit up.

Healthcare is no different than food, shelter, clothing, and other necessities — which are commodities. We consume those resources, and those resources are constrained by scarcity. The use of the word “consumer” is apt in this context.

Healthcare is no different than food, shelter, clothing, and other necessities — which are commodities. We consume those resources, and those resources are constrained by scarcity. The use of the word “consumer” is apt in this context.

I’m not interested in debating Republican talking points, I just wanted to point out that this chart, although pretty, represents the Republican view point, not the Democratic one.

I’m really worried that US citizens may be taken in by the right- wing propaganda suggesting the NHS isn’t popular or appreciated in the UK: it is- check out the BBC news “Have Your Say” website.
In our country people don’t die because they can’t afford healthcare. In the US many do. And many others endure chronic pain and disability because they can’t afford treatment. And that in the richest country on earth…
Yet the Good Ol’ Boys call our system evil. Wake up USA, these swines are protecting their wealth, not your health.
Raise your game. Ensure everyone gets the basics, and let business take care of the luxuries. Food, water, warmth, health are not commodities, they are necessities. If you want to call yourselves civilised on your side of the pond you need to recognise that.